Disease Surveillance and Epidemiology

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IHR Core Capacities at Points of Entry [PDF 1.3 MB]

The International Health Regulations, or IHR (2005), require countries across the globe to develop and strengthen the core capacities at designated international points of entry (PoE) such as airports, ports and ground crossings by June 2012. This includes strengthening public health routine and emergency preparedness and response at designated PoE. In order to review progress made under IHR (2005) at PoE, and to agree on priority areas to strengthen surveillance and response at PoE, a Regional Meeting on IHR Core Capacities at Points of Entry was organized in Colombo. Sri Lanka, on, 4-16 July 2010. This meeting brought Member States together to determine current strengths and weaknesses, and identify follow-up actions at national and regional level to strengthen core capacities at PoE. This report summarizes the deliberations of the meeting and outlines the responsibilities of the Member States and the role of WHO in meeting the obligations of IHR (2005).

Development of an Evaluation tool for Assessment of National Pandemic Strategic Responses in Member States of the South-East Asia Region [PDF 152 KB]

Pandemic influenza (H1N1) 2009 emerged in North America in April 2009. By the time the pandemic was declared over on 10 August 2010, at least 76 302 cases of Pandemic (H1N1) 2009 and 2054 deaths had been reported from the South-East Asia Region. A careful assessment of national responses and the support provided by WHO would yield important lessons for the revision of national pandemic preparedness plans, and to identify gaps where additional technical support may be required to strengthen core capacities, as required under IHR (2005). In order to facilitate a review of national responses, a proposal was therefore made to develop a regionally appropriate pandemic response assessment for use by Member States. With this objective, an informal consultation with invited experts from the Region was conducted in New Delhi from 22-24 November 2010 to review and revise a draft assessment tool. This report provides an account of the proceedings of this meeting and of the guidance provided to improve the assessment tool.

Public Health Research Agenda for Influenza in the South-East Asia Region: A review of current status and needs [PDF 355 KB]

Influenza is a global public health challenge. Insufficient knowledge of it in many areas has hampered capacity to prepare and respond to pandemic influenza as well as zoonotic and seasonal influenza epidemics. The gaps in knowledge can only be filed by appropriately targeted research. Based on this, WHO had coordinated the development of a Global Public Health Research Agenda for Influenza. There was a need for a Regional research framework to adequately address the priorities and the specific needs in the countries in SEAR. This working paper reviews the current status and needs for a draft Regional Framework for a Public Health Research Agenda for Influenza.

Strategy for coordinated approach to prevention and control of acute diarrhoea and respiratory infection in the South-East Asia Region Regional Office [PDF 1.8 MB]

Acute diarrhoea and respiratory infections (ARI) are the two leading causes of mortality in children under age 5 worldwide, with the highest burdens being in sub-Saharan Africa and in countries of the WHO South-East Asia (SEA) Region. The burden of these diseases is also high in other age groups. Achieving the Millennium Development Goal on child mortality, MDG-4, in the Region will not be possible without making coordinated efforts to both prevent and control these diseases. A tangible reduction in morbidity will also require addressing the problem across the age spectrum.

WHO Regional Technical Advisory Group (RTAG) reviewed the current situation and available interventions in 2008. Based on the advice of RTAG members and on regional and global experiences, this strategy document focuses on the coordinated approach to prevention and control of acute diarrhoea and respiratory infections across the age spectrum. The strategy emphasizes integration of preventive interventions with improved case management, at both community and facility levels and in all age groups. It also highlights the significance of coordinating efforts to mobilize communities, provide appropriate training, and conduct monitoring and research to strengthen the preventive and control interventions

Operational Guidelines on Plague Surveillance, Diagnosis, Prevention and Control [PDF 1.7 MB]

Operational Guidelines for Surveillance, Diagnosis, Prevention and Control of Plague The Operational Guidelines on Plague Surveillance, Diagnosis, Prevention and Control were first published by the WHO South-East Asia Region in 2004. These were revised and updated in the context of new case definitions adopted in 2006 and the enforcement of the IHR (2005). The revised International Health Regulations (IHR) 2005, which came into effect in June 2007, require notification to WHO of the occurrence of a suspected case of plague in an area not known to be endemic for plague. These revised and updated guidelines of 2009 provide comprehensive knowledge and information on plague epidemiology, surveillance, diagnosis, case management and prevention and control, and can be adapted by Member States to suit their technical requirements.

Avian Influenza in Bangladesh and India: Report of the High-level Consultation 27-28 August 2008, Dhaka, Bangladesh [PDF 3.2 MB]

SEA-CD-181 To strengthen cooperation for combating avian and pandemic influenza, a “High-level Consultation on Avian Influenza in Bangladesh and India” was held at Dhaka, Bangladesh on 27-28, 2008. The situation in the Region and in both countries was presented at the consultation. The response strategies of Thailand and Indonesia with health care facility preparedness in Thailand were shared. A round table discussion was held on: Cross-border issues, surveillance capacity and response, and Rapid containment at border areas. Joint recommendations were issued at the concluding session of the consultation.

Guidelines for Prevention and Control of Chikungunya Fever [PDF 588 KB]

SEA-CD-182 Eighteen vector-borne disease specialists and public health professionals from Bangladesh, India, Indonesia, Maldives, Sri Lanka and Thailand together with experts from WHO SEARO and headquarters shared their knowledge and experience on chikungunya fever. The discussions brought forth the need to develop guidelines for the prevention and control of chikungunya at the regional level for SE Asia. The general objectives of the guidelines are to assist member countries in preventing and controlling chikungunya fever by surveillance, case detection, outbreak investigation and by triggering necessary public health actions.

Implementation of international health regulations (2005): Report of the second regional meeting of the National IHR Focal Points, Colombo, Sri Lanka, 23-25 June 2008 [PDF 588 KB]

SEA-CD-183 In accordance with International Health Regulations (2005), Member States have committed to develop and maintain public health core capacities as defined by the Regulations. Recognizing the contribution of sharing experiences and lessons among Member States, WHO organized the first Regional Workshop on Implementation of IHR in April 2007. This report is a compilation of the Second Workshop organized by WHO in collaboration with the Ministry of Healthcare and Nutrition of Sri Lanka during 23-25 July 2008.

Integrated Disease Surveillance in Democratic People’s Republic of Korea: Report of the joint CSR and IVD review 15-26 September 2008 [PDF 294 KB]

SEA-CD-184 This report summarized activities undertaken in DPRK to conduct a systematic assessment of national integrated disease surveillance system. It is emphasized on assessment of the early warning capacity, routine reporting system, data analysis, laboratory capacity and outbreak investigation and response. It identified strengths and limitations with recommendations and plans for improvement. This review was a joint effort between CSR and IVD of WHO Regional Office for South-East Asia.

Communicable Diseases in South-East Asia Region: A snapshot of events and actions, 2007 [PDF 144 KB]

SEA-CD-168 TECHNICAL ASSISTANCE FOR NEGLECTED TROPICAL DISEASES

Assignment period – 3 December 2006 – 17 May 2007

Dr V. Kumaraswami, WHO Short-term Professional

Regional Meeting on Zoonotic Diseases – A report of the Meeting [PDF 809 KB]

SEA-CD-174 The three-day Regional Meeting on Zoonotic Diseases took place in Jakarta, Indonesia from 6 to 8 November 2007. Recent outbreaks of SARS, Avian Influenza and Nipah virus disease in WHO’s South-East Asia Region have demonstrated the vulnerability of the countries in the Region to emerging and re-emerging infectious diseases. Controlling some of these diseases requires functioning systems for early detection and response to zoonotic diseases. The Meeting discussed and arrived at a consensus on a regional strategic framework for prevention and control of zoonoses and to identify mechanisms for its implementation at the regional and country levels. The publication elaborates on the deliberations and outlines the recommendations made at the Meeting with a request to WHO to take a lead role in the implementation of the Regional Strategic Framework in coordination with other partners.

National Consultation on Avian Influenza, Report of the Meeting, Jakarta, Indonesia, 8-9 November 2007 [PDF 377 KB]

SEA-CD-175 A national consultation on avian influenza (AI) was held in Jakarta, Indonesia from 8 to 9 November 2007and attended by experts from WHO, FAO and UNICEF, donor agencies and from Bangladesh, Indonesia, Myanmar and Thailand. During the consultation AI situation, particularly in Indonesia, was reviewed with respect to human risk and determinants of high mortality. Experts also discussed to identify gaps in knowledge and strategic approaches and outlined activities required to fill these gaps. This publication elaborates on the reviews and recommendations made by these experts. As a priority, the consultation proposed strengthening of AI surveillance and response at all levels; enhancing early recognition of human cases in low-care settings; conducting a study to understand the role of environmental contamination in human infection; developing community-based risk communication strategies based on the result of socio-behavioural study; and conducting data analysis of recorded human cases and share best practices related to clinical case management.

Regional Task Force Meeting on Avian Influenza: Report of the Meeting, Bali, Indonesia, 3-5 March 2008 [PDF 2.14 MB]

SEA-CD-177 The first meeting of the Regional Task Force for Research on avian influenza was convened 3-5 March 2008 in Bali, Indonesia. The establishment of the Task Force followed recommendations of Advisory Committee on Health Research (ACHR) in March 2007. It was attended by nine Task Force members. During the consultation, regional AI situation was reviewed and overview of selected research topics presented. The Task Force members discussed gaps in knowledge in the following areas: surveillance in clinical and

community settings, clinical management, virology, socio-behavioral change, socio-economic impact, the animal-human interface and vaccine development. Systematically addressing these knowledge gaps would have implications for capacity –building in countries of the SEA Region, especially since research capacity is not balanced between Member countries. Prioritization of specific research areas should also be undertaken at a country level according to the context.

Guidelines for Clinical Management of Chikungunya Fever [PDF 844 KB]

Guidelines on Clinical Management of Chikungunya Fever As Chikungunya Fever is a new and emerging disease, it has not received sufficient coverage yet in the medical curricula of Member States. Specific treatment is not available, and there is no vaccine for the prevention and of Chikungunya Fever. It has therefore become imperative to develop guidelines, based on the limited clinical experience gathered form managing patients so far, for appropriate management of patients in communities and in health facilities. Experts engaged in managing patients with Chikungunya Fever in the Region were brought together by the WHO Regional Office for South-East Asia to outline guidelines for managing various situations and stages of the disease. This publication is the end result of that exercise and is intended to assist health-care providers in planning and implementing appropriate care to patients with Chikungunya Fever according to their actual clinical conditions.

Epidemiology and its application in programme development and management: A concept note [PDF 278 KB]

SEA-CD-179 Epidemiology is a fundamental science, essential for the study of disease occurrence, distribution and determinants, and the application of this study in disease prevention and control. Given the disease burden in the South-East Asia Region, strengthening of epidemiological services and promotion of epidemiological thinking as an integral part of programme development and and management is a particularly important. This concept note articulates the relevance of and the need for this approach in the Region, identifies a few key initial steps to be taken in this context and outlines certain expected outcomes.

Zoonotic diseases: A guide to establishing collaboration between animal and human health sectors at the country level [PDF 504 KB]

Zoonotic diseases: A guide to establishing collaboration between animal and human health sectors at the country level This guide was developed to assist countries and areas in achieving sustainable and functional collaboration between animal and human health sectors, which is crucial to addressing the challenges posed by endemic, emerging and re-emerging zoonoses. It outlines step-by-step actions to develop appropriate collaborations in the Asia Pacific Strategy for Emerging Diseases (APSED) zoonoses work plan.

Prevention and Control of Chikungunya in South East Asia [PDF 164 KB]

Chikungunya fever has become a public health problem in the South-East Asia Region. The purpose of this report is to describe the magnitude of the problem including its risk factors that can be reduced or eliminated through appropriate corrective action, in order to develop policy to prevent and control the disease as well as to identify the funding sources.

Early Warning and Response to Outbreaks and other Public Health Events: A Guide [PDF 290 KB]

These guidelines were developed to provide Member States with the technical information needed to establish an early warning component as part of their existing surveillance systems in order to comply with the core capacity requirements of the IHR. These are addressed to health policy-makers responsible for strengthening the early warning and response mechanisms of an existing surveillance system, Epidemiologists at the national, intermediate and local level and Rapid Response Teams at the national, intermediate and local level.

Implementation of International Health Regulations (2005)[PDF 185KB]

Implementation of International Health Regulations (2005) The threat from infectious diseases has over the past few years increased mainly due to their emergence and re-emergence, and increased international travel and trade. Severe Acute Respiratory Syndrome and avian influenza are just two recent examples of such threats with serious public health and socioeconomic implications…